Medical Certificate for Seryice at Sea
[Issucd under tht Authority of Director*te General of Shipping, Gofi. of India under RuIe 4 of M.S.
ii!{edicalI Exarnination) Rules, 2000 as amendecll
MORE PRASHANT ANIL
iSeaiiru liarne: Lasl I:u.sr. N{iddle)
18t04t1994 MALE
Daie r:f Ei*h : idrVm*;y;.-11y I (ier*ir:. ifufeieriem::l* i
T 5478i 87 irH
{}rl.:rnber *iC}Cl Passp-*r#other vulid id.ntitic,:tioa d*otrr:ent
Indiari __ ". DB",
r+.i*-r i-_vpe *f dcrunerrt) iNalianelityi rt!ic
hasbet. e:<.i.ure,i1,r- ilR RANJlT SONAYE Reg.No" 44503
(Name of Medical Examina and approral no_)
DGS Approval No. MAH/MUM/1 17
andhas been lbund lilruofir* fcr ser'ice ar sea in tbe job ol PHOTOGRAPHER
* If unfit, reasons tc be qpecified.
Also, to specify u,hether ternporary/permalett u.lihress.
(a) The healjlrg andsight ofthe sealarer crncerned, and the colour vision ia tLe case of a sealaaer tobe
employed irr capacities wirele iiLless ibr the wort to lx peribnnctl is liable to be allesled by deiective
soloul visi$[, ale ail satisfactory: and
(b) The seali{er conosfiled is not rutl'ering froin :ury metlieal corulitioa likel to be aggravaterl
br., ser-vice at
sea ortorender the seafarefunfit torsuch service or to eadanser the health. of
oiher persons on board.
{c) The Sealarer complies wit} the equke.ments specilierl il TableA-ll9 of STCW Code (i.e,
Miailnai in
service eyesight standalds tbr seafarers), TableB-I/9 of STCW Codr
ii.e. Assessment of minimum
enkl' level atd il-service physicai abilieies lbr seafarers),,and Regulatiou 1.2- StaadardA-1.2 &Gu-rdeline
B-1.2 of the Maiitime Labou Convanlion 20{,6.
a6fi1t2a2o irnmsoPARA (W
(Date & Place of Medical Examinaiicnl
Dr. RAFil.IIT SOIUAYE
[Ui.S.D. Ortho lSignature ol the Medical Eraminer)
Reg" F{o. 445E3
OGS Approvat No. MAH/M Utlitltltl}ll
Dr. REnjit Sonaye f linie
i 0.01-?*20 Sidd hivinayak eomplex,
(Serial numba of tbe Ccrtifiate) StatiGn Road, Nalasopara West. 4e1203
Fhone: 0250 2406gCl
Email Addreaqi dr!"EniitEqluye@qgnELepry
FIT FOTq $EA I:JiHEqVICH iAdct"iss with E-rneil Ill & Cr,rtar:t Nc.
A$ PER MLC . 2006 ci' &{erii*d E:-anrine:J
Thrs Certilfuate cspires on*. 05fi1t2A21 011icla1 Stamp o1'&e l\{edical Er:aminer
{Day, Month, yeur)*
(*Not rnore t}an 2 ye&s from lhe ilate rf isste, unless the sealhrers is tnder the age of
lg, in which case ihc
maximum period of validiry of th.e Medicai Certiticate *ra1l be I yeu.).
I{ *ie pcriod ol 1,a.fiditv. of the merlical cerlillcalc er1:rres in Lhe course .f r'ovase, thcn ihc medical certillcate
shall eontinuc to be [r lirree lor not cxceediirg tlr:ce mrnlh;; liorir rhe rllrc oi erprry. or rLntil t5c ncxt
-a,puriorl
prui of call qtere-at approved Mtdrtal iiraminer is availahle, and thc seai'ars.uan lut cran,ure,l rn,j ohr..r"
Lener.;ed tnctLcal rertiiicale Jirxu that lleilical Iiramrnqr..
NotB; Th€ irrincipal ruls were published in tha) Ga;ette of lndia, Part ll, sectior| 3, sub se{tion (i) vide Notifi.ation Number G.5,R.57
{E) dated the 19,i
]anrleru lB{10 rr ir^ r-o
Arnexure :!_
slGfiT 1E5r cEniTrFtcATE
New EntrflFeriodicr
..
Sefere$6ellg'' 10-01 -2020
Ftflf,Name,. : ,,,1 MORE PRASHANT ANIL
&ahk r,
PffflBSID,No,.:,'
Sae&:F,txed.et*h
r
:,. ii
PHOTOGRAPHER
T 5478187
181A411s94 MUMBAI
ru_lr*. ^
':'.
Colstrsr
I r
€yB.
_:.::'l,l : ;'
l BLACK
Lr*
LG
'., :,. "i: , :
ldendff*atia*Hstsi
HEIGHT. 172 CM WEIGHT- SSKG D!",, EY
Eight E)€ Left €ye &th Elesr=
. t/ir[
. Besult -
Unaided
Distance Visiar
a/3 6/6 $f;S Hppror :lpq6fgAHil,tUr 71t20
Aided .6/6 b/b 6/6 PASS
Unaided N6
Near Vision
N6 N6 PASS
Aided N6 N6 N6 PASS
HorizontalPlane NORMAL It'IORMAL NORMAL PASS
Field of Vision
Vertical Plane
NORMAL NORMAL NI0RtrdlAL PASS
lshihara NO COLCIUR BLINDNESS HASb
&sry{urtEq
lantern /Others
.1
n,.*r4!!lll
r, SONAYE
Has meVnot metr, siEht standard for his/her designated rank/positioned as set out in Annex-l$ lAnnex-
lll* for
t/)
l//m-<:<-2.*z-
Signature of the fuIedical Examiner
DR.
IT ry$"ry{tr s0idr\yE cLlHtc
_ sruEHA s.gasplTAf=
Complex, Statisn Rcaii,
at,r)rA!4F01$Fs is .S-..V
_Nafie
sopara; patghar .+ot aiJl;.
Tot.0?5CI-raiatsi t
FIT FOR SEA $HRVICE
AS PER ffiLC * , ,}CI6 -
1) Thi! certi$Gte ir valid for tlgsgg-f'om the rbore date. ffenr €fitqy righatest {ertifi.at€s shculd
be
retained by the qndidate till his a{tfue sea career.
2) S*afrrer aggrieved by the de{ision of the lt€di,cal Eteminer may appral ar per the provi:ion
cf {he
M5, (Medicat Ex6n{nation} Rules. 2d00 as amended.
*
Delere if nor ap$kable
iloteThe principal rult5 rryere publirhed in the C:azette of lndia, Pirt$,i€ction 3, 51;j"lectio11
{iivide
htotifi.ation Nun&erG.S.fl.S?{€} dat.d the trg Gjanuary 20Oo.
' . IrjS6.S*:Jl*l11ll'lilttr&{€}
.I ALOXSTVASTAVAAddI.S€ry
t
